Which patient should the nurse assess first?

The priority in patient assessment is often determined by the severity and immediacy of potentially life-threatening conditions. In the scenario provided, the patient who is sneezing after subcutaneous immunotherapy is exhibiting signs that may suggest an allergic reaction. While sneezing alone may not seem severe, it can indicate a hypersensitivity response to the administered therapy. This situation can progress to more serious complications, such as anaphylaxis, especially if the patient has a known history of allergies.

The other patients, while presenting concerning symptoms, are likely not in immediate danger in comparison. For example, the patient with urticaria after receiving an IV antibiotic does require assessment due to the risk of anaphylaxis, yet there is no indication of more severe symptoms like respiratory distress or systemic reaction at that moment. The patient suffering from graft-versus-host disease with severe diarrhea is also in a critical situation that requires attention, but severe diarrhea is a known complication in such patients and may not require immediate intervention over acute allergic signs. Meanwhile, the patient with muscle stiffness due to multiple chemical sensitivities is concerning, but their condition does not present the same immediate risk of a rapidly escalating allergic reaction.

Thus, assessing the patient with sneezing after immunotherapy first allows for prompt identification and